Women who suffer from preeclampsia and other hypertensive disorders during pregnancy are up to four times more likely to suffer heart disease in the future, but many are not aware of the dangers.
As part of the Making the Invisible Visible campaign that runs throughout June to raise awareness of heart disease among women, the Heart Foundation is urging mothers to see their GP for a heart check if they suffered blood-pressure related complications during pregnancy.
Heart disease is the biggest killer of women in Australia, accounting for 22 deaths each day – three times the rate of breast cancer.
The Heart Foundation's Women's Heart Health national spokeswoman Julie Anne Mitchell says up to 30,000 women suffer from hypertensive pregnancy disorders each year in Australia, and research shows these conditions can increase their risk of heart disease by up to four times.
"Many people think that heart disease is an old man's disease, but the fact is heart disease doesn't discriminate; it affects both genders," Julie Anne says.
"Research now indicates that women who have suffered from gestational hypertension, preeclampsia and eclampsia might be at higher risk of developing heart disease."
Julie Anne says many pregnant women are not told about the possible long-term implications to their health.
"We are concerned that the care often stops [after the birth] for the mothers, when a focus on maintaining good heart health and regular checkups over the coming years is essential for long-term health and wellbeing," she says.
Jo Dean developed preeclampsia during both her pregnancies but was never advised she was at higher risk of heart disease later in life.
Jo was 31 weeks' pregnant with her first child when her GP noticed her blood pressure was very high and sent her straight to hospital.
She was diagnosed with severe preeclampsia and was hospitalised for two weeks before her baby was born six weeks' early via emergency caesarean.
Jo says her blood pressure returned to normal straight after the birth.
During her next pregnancy two years later, her blood pressure shot up at about 35 weeks' and she was admitted to hospital. Her baby was born soon after and her blood pressure again returned to normal straight after.
A decade later, in January last year, Jo was on her regular cycle to work when she began to experience chest pains.
"I thought it could have been fitness-related because I hadn't been on my bike over Christmas," she says.
But when they pain returned over the coming weeks whenever she attempted to cycle uphill she became concerned.
"Sometimes the pain was quite intense. It was chest pain but sometimes it radiated down my arms. I would stop and get off my bike and think, 'I can't get up this hill'," she says.
Eventually, Jo decided to see her doctor. Despite being a fit and healthy 43-year-old, her GP suggested she have an ECG to be cautious.
The ECG came back positive, so she was sent to a cardiologist, who originally thought it may have been a false result.
Jo decided to have an echocardiogram and was going to wait six weeks for the cardiologist to return from holidays but decided to have it done sooner. During the test, Jo says "it became extremely apparent there was a big problem".
Jo was admitted to hospital the next day to have an angiogram, which showed she had a 90 per cent blockage in the major artery of her heart. Because of its location, the cardiologist could not put a stent in straight away and Jo was told she would need open-heart surgery.
Jo's heart surgeon suggested robotic heart surgery, which meant her sternum could remain intact and she would not require a heart/lung bypass machine during the operation.
She underwent surgery in May 2017, during which the surgeon redirected the heart's blood flow around the blockage.
Despite a much better recovery time than traditional open-heart surgery, Jo says she "still felt like I had been hit by a bus". She spent eight days in hospital and many more weeks recovering.
Jo says it was during a consultation with her cardiologist that the link with the preeclampsia she suffered during her pregnancies was discovered.
She says that had she known about the risk, she could have taken steps to safeguard herself.
"It's well known in scientific research that there is a proven link. I do have a family history of heart disease, but much later in life. Preeclampsia is my only risk factor," she says.
"Had I known that before I would probably have been on blood thinners and statins, and cholesterol-lowering medication straight after my pregnancies.
"My cholesterol had never been checked. When it finally was checked it was elevated.
"Cholesterol medication probably would have stopped all the arterial plaque build-up that caused the blockage."
Jo says her lack of knowledge about her risk of heart disease could have proven fatal.
"I do think sometimes about what might have happened. I probably would have kept on riding my bike," she says.
"I do not know how close I came to having a heart attack.
"I am extremely aware of how lucky I am, which is why I want to raise awareness, not to alarm people, but to make them aware."
Cardiologist Clare Arnott says women who have suffered preeclampsia and other blood pressure disorders during pregnancy are not routinely educated on their heart risk or offered appropriate follow-up after their baby is born.
"Currently in Australia, cardiologists and GPs are not generally taught about these conditions nor are they given clear guidelines on how to monitor and treat women after they have had their baby," Dr Arnott says.
"We are working with the Heart Foundation to not only encourage women to discuss this with their doctors, but to also ensure that health professionals have the right information to help support these women to look after their heart health."
Dr Arnott says women who have experienced vascular complications in pregnancy should not be alarmed as there are things they can do to reduce their risk.
"Not all women who have experienced these conditions go on to have heart problems, but if they do, we know that it tends to occur earlier than in other women, about 10 to 15 years post -pregnancy," she says.
"My advice to women would be to ask their doctor for a heart health check, be aware of their risk factors such as blood pressure, cholesterol and take steps to ensure they are physically active, not smoking and are eating well."
For more information go to www.invisiblevisible.org